Organization
HUMAN SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY BAUER (MIS COORDINATOR)
(618) 282-6233
Entity
Organization
Contact information
Practice address
101 MELMAR CT, SPARTA, IL 62286-1183
(618) 282-6233
(618) 282-6220
Mailing address
10257 STATE ROUTE THREE, RED BUD, IL 62278
(618) 282-6233
(618) 282-6949
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
01/08/2013
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